ART (Assisted Reproductive Technologies) are becoming part of the reality for many women and couples in their pursuit of parenthood, due to the increasing frequency of infertility around the world (World Health Organization, 2009).
Problems around ART include not only the health issues of women / couples, but also psychosocial difficulties (including financial, social and emotional), as well as bioethical and moral aspects for both family and medical workers, and for society as a whole. But since all these torments have one goal - the birth of a child, the main task is for this child to be healthy.
To do this, first of all physicians should be aware of the possible risks, but also parents too. It is also important to know what needs to be observed, what can be alerted and in what cases the doctor should be told, how the child was conceived, and in what cases it is possible not to disclose this information that is strictly intimate for the family.
The method of in vitro fertilization (IVF) and embryo transfer into the uterine cavity is considered to be one of the most outstanding achievements of the twentieth century. The birth of the first child “from a test tube” in 1978 was considered as a “technological miracle”, but at the same time gave rise to various theological, ethical and moral problems, which to this day provoke discussions and irreconcilable disputes about the limit of permissibility of introduction into “ holy of holies "- the nature of the creation of their own kind.
The method was originally developed to overcome reproductive problems caused by obstruction or lack of fallopian tubes, but now the indications for assisted reproductive technology (ART) include various causes of infertility (endocrine, idiopathic, male factors, etc.).
Thus, the need to assess the effects of ART in the treatment of infertility is growing in parallel with the emergence of new technical capabilities and an increase in the number of children born after IVF.
Despite the fact that each person may have his own view on the admissibility of ART, however, in medical terms, realizing that this method may be the only hope for many couples to experience the joy of being parents and to see the continuation of the race, we, as pediatricians, can only be ready to properly evaluate, observe and, if necessary, treat these children so that they can be full members of society.
The complexity, high cost, high frequency of failure of IVF attempts, a significant impact on the health of the woman, a serious psychological burden and the rehabilitation period after the failure can hardly make this technology meaningful for changes in demographic indicators.
Pregnancies due to IVF in the world make up less than 2% of all births. In our country, this percentage is even lower. But still, according to data for 2014, more than 5,000,000 children worldwide were born with the help of ART. And these are already sufficient numbers to assess the effect of IVF on health indicators and the development of a methodology for monitoring such children with a focus on the most problematic aspects of their health.
To assess the impact of IVF technology, attempts are being made to compare the outcomes of children's health and development in IVF pregnancies by the effect of:
- On the technology of ectopic fertilization and subsequent embryo replanting
- or those reasons that led to the need to resort to technology ART.
When analyzing the outcomes of pregnancies and the status of children born after applying the methods of ART, we can distinguish 6 main areas:
- the course and outcome of pregnancies after the application of ART methods,
- frequency of congenital developmental abnormalities,
- cancer risk
- growth, physical and psychomotor development,
- endocrine disorders
- genetic diseases.
In a very short and affordable manner, we will provide basic world data, including domestic experience, for each of these points.
Perinatal outcomes (course and outcomes of pregnancies after the use of ART)
Unfortunately, with ART, not every cycle and “replanting” or embryo transfer ends in pregnancy. Probably because, nevertheless, pregnancy is a process regulated "from above". Mathematical calculation, saturation with hormones, the choice of embryo insertion site does not always end in victory, especially if the woman’s psychological state is extremely tense, the desire to receive the cherished enhancement of the chorionic hormone is very large, but something in the depths constantly whispers that all efforts are in vain. This psychological state is pursued by many women who go through this procedure, and more often than not, pregnancy does not occur.
Now there is even a special direction, which is widely discussed at sessions of the RAHR (Russian Association of Human Reproduction) - psychological support for a couple before pregnancy and in case of failure. Different couples suffer this “loss” in different ways, and the approach to correction, the creation of conditions for further “struggle” is absolutely individual, but also absolutely necessary for a favorable conclusion - the onset of pregnancy and childbirth. A confirmation of the above is the fact that, despite the rapid and qualitative improvements in the technology itself, even in the best clinics, the average number of attempts is 2.5-3 per pair.
But the successful onset of pregnancy does not end there. The main thing is a very close medical observation and maintenance throughout this period. Not excessive treatment, but control. The most dangerous is miscarriage, that is, premature onset of labor. The most risky time is 27-30 weeks. It is during these periods that it is necessary to be especially careful and cautious, to monitor the condition of the fetus, not to overwork, not to wear weights, not to change the climate, not to be subjected to overloads, etc. Usually, if everything goes well, the woman calms down a bit and, taking into account the well-being, ceases to be protected, which can be one of the main factors of sudden bleeding, the discharge of amniotic fluid, etc., that is, the onset of labor. In addition, after ECO-technology, multiple pregnancies are not uncommon, which in themselves are more difficult for both gestation and delivery.
Thus, the main advice and wishes for couples who have come to a long-awaited IVF pregnancy: do not relax, see one doctor and attach to a maternity hospital, better to the perinatal center, where cases of birth of such children are not uncommon, where there is a children's reanimation and experienced neonatal service .
If a child is born premature, then everything is determined not by how he was conceived, but by what degree of prematurity, body weight, how he adapts to extrauterine existence and what level of professionalism of medical staff and technical capabilities of the institution where he is nursed. He, unfortunately, will be characterized by all the problems associated with prematurity, and in order for the child to grow up healthy, he, like all premature babies, will need special supervision of specialists.
The term “congenital developmental anomaly” or “congenital malformations” (CDF) refers to a wide range of defects that are detected immediately or some time after the birth of a child.
Most of the current research indicates an increased risk of CRF among IVF children. In this regard, for IVF pregnancy, it is necessary to regularly under the prescribed terms (10-12 weeks of pregnancy, 18-20 weeks, 32-34 and 38-40 weeks) an ultrasound study, preferably in 3D projections, for a thorough analysis of the fetal condition, assessment his organs, in order to further establish the presence of a defect in the womb and to carry out prenatal counseling on its correction with the appropriate choice of the Center for delivery. In principle, such a system, which is approved and adopted throughout the world and in our country, should be strictly implemented during any pregnancy, which will eliminate the defects that are incompatible with life and keep children healthy when it is possible with correct and timely correction of violations .
It is still not clear in the world whether the increased risk of CDF after IVF is associated with genetic factors, causes of infertility, environmental influences or directly with the IVF procedure itself. Most authors and researchers are inclined to believe that the “fault” is not the IVF procedure itself, not the cultivation of embryos in special environments, but internal factors leading to infertility, age and diseases of future parents.
Genetic disorders and pediatric cancer
In recent years, foreign literature has widely discussed the possible relationship between the health features of children born using ART methods, and chromosomal and genetic diseases. Large international studies have shown a slight increase in such diseases relative to the rest of the population. It is clear that some types of infertility can be associated with genetic defects in parents, which they do not show, but can be very pronounced in the offspring. Most likely, long-term infertility and, as it were, the natural “rejection” of embryos were connected with this. The ART method partially helps to overcome this obstacle.
In some cases, some genetic diseases, extremely rare, it is impossible to determine in utero because of the trauma and complexity of the search. But these diseases, as random, rarely, but can occur in any family. However, today, most of the most common chromosomal and characteristic for IVF genetic diseases are known, and a survey on their identification should be carried out before the "replanting" - the transfer of embryos. The material costs of this are more than worth minimizing the risk of having a sick child.
Another burning issue is the likelihood of oncological pathology. In the last 10-15 years, with an increase in the number of babies born after ART, there have been reports of an increased risk of embryonic tumors, including leukemia, neuroblastoma, retinoblastoma, histiocytoma, among children born using ART methods . This forced developed countries to create National Registries that track the state of health of children born by the IVF method for quite a long time (now for 18 years already). Such countries include Sweden, USA, UK. The absence of a statistically significant increase in oncological diseases in children born as a result of IVF with respect to population risks is shown on a large population and continuous sample. There is also no connection with the increase in nephrological, cardiovascular pathology, impaired blood formation, etc.
Then what requires special control from these children?
Evaluation of indicators of physical and sexual development among children IVF
Most studies evaluating the growth of children after IVF at different age periods and up to 12 years of age do not reveal differences in comparison with population indicators.
On the contrary, the fact of higher growth and body mass indicators in children born by the IVF method has been established on a large population . This can be especially noted in children aged 5-6 years, even when adjusted for parents' height. It is significant that even born very premature infants of IVF with very low body mass (
Children IVF, developmental features, health problems, risks of malformations
What is the difference between children after IVF from normal?
In vitro fertilization is a modern reproductive technology that helps couples, even with severe health problems, become parents.
But many future fathers and mothers, deciding whether to go to the clinic, think about whether their child will be healthy, without any developmental abnormalities and genetic defects? This question is associated with a large number of false prejudices, but there are real risk factors. About the features of children born from IVF - in our article.
For over 15 years, the European Association of Reproduction and Embryology has been keeping statistics, which takes into account data on children conceived naturally and in vitro. According to her, babies born as a result of normal pregnancy, in 3.5% of cases, suffer from genetic diseases, defects and other developmental disorders.
In the case of babies born after IVF, this figure is 4–4.5%. Experts point out that the difference of 1-1.5% is primarily related not to the conception procedure itself in the laboratory, but to the fact that it is usually preceded by long-term treatment of infertility by alternative methods.
In the course of it, hormonal drugs and medicines are prescribed that somehow “beat” the woman’s body and its reproductive health.
According to statistics, the method of conception does not affect health
It should be borne in mind that in vitro fertilization, in principle, couples come up with some problems, and this factor also does not work in favor of statistics of this reproductive technology. Among the frequent patients seeking IVF are couples over 40 years old, people with chronic diseases, sexual dysfunction and other "features." It is they, and not the in vitro fertilization procedure itself, that affect the quality of the genetic material used for conception. This factor is corrected by pre-implantation diagnosis of embryos, but it still has an impact on the health statistics of children after IVF.
Another real risk factor is multiple pregnancies. For example, in the long and short protocol of IVF, usually 2 embryos, a maximum of 3, are transferred to the uterus after in vitro fertilization. In addition, 2 embryos can form from each of them.
That is, if 2 embryos take root, there is a possibility that a pregnancy with 4 fetuses will develop. But even in the event that a woman after IVF becomes pregnant with twins, gestation and childbirth will be more difficult than with one baby.
Multiple fertility is often associated with neurological problems due to premature birth, hypoxia and other indirect factors.
About the risks you need to ask the doctor
Myths about the problems of "luxury" children
The essence of the in vitro conception procedure seems to many to be risky and contrary to nature, although it is based primarily on natural laws.
The onset of pregnancy is hampered by various prerequisites, and in vitro fertilization simply helps to circumvent such obstacles.
There are various protocols of this technology, some are carried out in the natural cycle, others are stimulated, but even in the second case, a woman takes hormone preparations that are related to her natural therapy to prepare for the puncture of the follicles.
The process of fertilization obtained from the expectant mother or donor oocytes is similar to the usual one - the sperm from the seminal fluid in the nutrient medium is connected to the egg cell independently or using ICSI (intracytoplasmic injection).
Further fusion of germ cells, their division and the formation of the embryo go without any intervention. All that remains for the doctor to do is to select the highest quality embryos in a few days after fertilization and return them to the woman’s body.
"Ekoshny" children - special?
Despite the “transparency” of the process of in vitro fertilization, often future parents are afraid of delayed problems in the development of the child. Most of the fears are myths that contradict facts and statistics.
Myth 1: children born to IVF are barren.
On July 25, 1978, Louise Brown was born - the world's first test-tube baby. Now she is nearly 40 years old, she is a mother of two children and has given birth to them independently, without using assisted reproductive technologies.
30 years ago and in Russia, the first baby was born, conceived in vitro, - Elena Dontsova, not so long ago she herself became the mother of an absolutely healthy child.
These cases are the first, but not the only ones: official statistics show that the need to use in vitro fertilization in the future depends not on the method of conception, but on the state of human health.
And he, in turn, is determined not only by genetic factors, but also by way of life, the absence of bad habits, the presence of diseases in history and other factors.
The experience of IVF has more than 40 years, while the statistics on infertility has not changed for almost half a century. Problems with conception are still faced by 13-17% of the population.
There is no direct connection between in vitro conception and the inability to give birth to a healthy child on their own in the future.
IVF myths are not supported by the facts.
Myth 2: IVF children have no soul
Духовные вопросы крайне сложно интерпретировать в контексте современной и постоянно развивающейся медицины. In religious circles there is a perception that if birth as a sacrament is not led by a divine principle, but a person is a doctor, then a child conceived in this way is not complete.
Medicine does not consider such questions, but the onset of pregnancy and the chance to become parents change the lives of infertile couples for the better. Physiologically and emotionally, children born after IVF are no different from other babies.
They are also tied to their parents, need care, grow up to be full-fledged members of society and learn any profession, can have their children - by the way, on their own, without using assisted reproductive technologies.
A stranger will not be able to guess whether the child was born in vitro, and the statement about the absence of the soul of such a child is either a subjective opinion or just a prejudice.
The nature and development of the child's way of conception does not affect
Myth 3: Children after IVF are born with defects and abnormalities.
In a simplified form, the procedure of in vitro fertilization is as follows:
- The couple undergoes a full examination, during which all aspects of the health of the parents that may affect the development of the fetus are evaluated.
- In the absence of restrictions and contraindications, the preparation of a woman for the collection of oocytes begins - hormonal or alternative.
- At the optimum time, the doctor using the puncture picks up the follicles in which the ovum ready for fertilization has matured. In parallel with this, the future father receives seminal fluid.
- In the laboratory, the germ cells of the parents are placed in a nutrient medium with ideal conditions for fertilization and the start of division of the embryo. The egg cell and the sperm cell combine independently or with ICSI.
- Within 3-5 days, the embryo divides and grows on its own. By the end of this period, preimplantation diagnostics is carried out. This is a complex of ultramodern tests, allowing to select the most high-quality and viable embryos and exclude genetic and other deviations from them.
- The most healthy and strong embryos are planted in the uterus of the expectant mother, where they are implanted and developed naturally.
Simply put, only healthy embryos are returned to the woman’s body after the puncture, which directly reduces the risk of any developmental defects. By the way, it is impossible to do this when pregnancy occurs naturally, and in this sense, IVF is a more reliable method for those who fear genetic diseases and similar problems in the development of a baby.
Can a “skilful” child have congenital malformations?
Myth 4: "Ekoshny" child is lagging behind in development
After replanting into the uterus, the embryo conceived in vitro develops naturally. The only intervention from the side is the prescription of hormonal drugs with progesterone, which increase the chances of high-quality implantation of the embryo and support pregnancy in the early stages.
These medicines, as well as conception in the laboratory, have no effect on how the baby will develop after birth. It is conceived from the same cells as naturally born children.
Its intrauterine development proceeds at the same rate, lasts 40 obstetric weeks and ends with the usual childbirth - independent or if there is evidence from the mother with a caesarean section.
After giving birth, the child is no different from others and develops in the same way as peers. Lagging behind in its development, as in the case of “ordinary” children, can be provoked by indirect factors - lack of vitamins and micronutrients, the choice of an inappropriate education or training system, etc. In addition, a child born after IVF - in the absolute majority of cases, the long-awaited, he "got" the parents with great difficulty. Because of his development, dad and mom can be treated more closely, which a priori eliminates the backlog from their peers.
Development does not depend on conception, but on the attitude of parents towards education and training.
Myth 5: Children born after IVF get sick more often.
Another common prejudice is related to the physical health of in vitro conceived babies.
In fact, the intervention of the doctor in the process of the birth of this child falls only on the stage of fertilization of the egg by the spermatozoon, and a similar procedure is carried out in the same way as would occur in nature.
At the same time, the most viable and healthy embryos are selected for replanting into the uterus.
Then they develop in a natural way, and the pregnancy of the expectant mother is carried out according to the standard state program with attachment to the antenatal clinic, regular check-ups, tests and screenings. After childbirth, the ekosny baby is given the same vaccinations as naturally conceived children. In terms of health and physical development, he is no different from peers, and
The child’s state of health does not depend on the mode of conception, but on the way of life — nutrition, physical activity, sleep and wakefulness, and other factors.
: What is the difference between children born from IVF and ordinary ones?
What is the difference between children of IVF and ordinary children - popular misconceptions about the development of children
The number of people suffering from infertility is increasing every day. Moreover, many couples, getting married, do not rush to have babies, but prefer to first accumulate capital and get on their feet, and then acquire offspring.
When they do decide on such an important step, their age passes the line of 30 years. Many couples have reproductive problems. The best option in such cases will be IVF - in vitro fertilization. But what will be the children born in this way? Learn about this from the article.
Are there differences between children of IVF and normal children?
Many women are fond of gardening and know that some varieties of fruit crops (for example, tomatoes, peppers, eggplants) need to be grown seedling, that is, first plant the seed in a specially prepared soil in a small pot, and then transplant the grown sprout in the open ground.
This is done so that the plant is more likely to ripen and give fruit. If the seeds of the same tomato are immediately sown in the ground, the fruiting process will be long, and the crop itself will be more likely to be attacked by pests.
One way or another, but in the first case, and in the second, the tomato produces fruits with approximately the same external and taste characteristics.
The same situation is with children born with IVF. The method differs only in the way of conception, and then the pregnancy itself proceeds in exactly the same way as for mothers who become pregnant by natural means.
It is not always possible to conceive without medical care, but there is always a chance to raise a full-fledged child, instead of looking for ghostly flaws in it.
IVF Children Myths
Despite the rapid development of medical technology and the continuous improvement of infertility treatment methods, a huge number of people still consider IVF as dangerous, and children born as a result of in vitro fertilization are either inferior or simply not like normal children.
There are many myths around this topic that can prevent the marital happiness of many married couples.
Here are four of the most persistent delusions:
- IVF children are inferior to their peers in the rate of physical and mental maturation,
- such guys have weaker immunity, and therefore they are sick more often,
- these kids are born with genetic pathologies,
- born by in vitro fertilization cannot conceive their own babies in a natural way.
Let us examine each myth in more detail.
According to statistics, children of IVF, on the contrary, are ahead of their peers in development. There are two explanations for this.
First, such children are usually long-awaited, and therefore more loved, than those who were born by spontaneous pregnancy. It is obvious that the father and the mother will not mind the soul in their children, and the time spent together will surely have a beneficial effect on the development of the personality.
And secondly, modern medicine is so scrupulous about the process of transferring a healthy embryo into the uterus, that it carries out PGD, a pre-implantation genetic diagnosis that completely excludes the possibility of having children with serious disabilities. In more detail about this method below.
There are no scientifically based data that would testify in favor of such a theory. IVF babies, as well as ordinary children, can be vaccinated and carry out preventive procedures.
INTERESTING! Those who believe in esoteric, it is important to know: Canadian researchers have shown that the biofield (aura) of IVF children is within normal limits.
The presence of defects and deviations
Since the fetus was conceived as a result of the merger of the mother egg and the paternal spermatozoon, it will be genetically similar to the parents, so the likelihood of developing certain inherited deviations is always possible. Usually, reproductive medicine services are already used by age couples, which can aggravate the situation.
In addition, the development of the organism is influenced by the ecological state of the environment, the lifestyle of the parents, and the peculiarities of the maternal organism. To avoid some hereditary diseases, doctors conduct all the same PGD.
According to statistics, congenital malformations occur in every thirty-fifth IVF child against every fiftieth baby born naturally. As you can see, the gap is minimal, and studies were conducted without taking into account the state of health of the parents.
In addition, scientists have proven that some genetic diseases, such as Down syndrome, are much less common in children with in vitro fertilization.
The first "test tube baby" was born in 1978, that is, exactly 40 years ago. Since then, more than 5 million “flowers of life” have been born this way. Many of them have already had their own little ones, which means that children conceived by in vitro fertilization are not at all fruitless.
For example, now Louise Brown - the girl who was first born by the miracle method - already brings up a beautiful healthy boy of 10 years old, born naturally.
However, science claims that problems with conception can be transmitted hereditarily, so it is possible that, since the parents had such problems, then the offspring may be sterile.
What do doctors say about IVF children
To increase the likelihood of engraftment, doctors transfer several embryos. Previously, it was 4-5 units, now this number has been reduced to two. Thus, pregnancy after IVF is often multiple. The probability of getting pregnant the first time is about 30%, and the second or third is as much as 70%.
Quite often, these children are born prematurely, ahead of time, as a result of a large load on the mother's body due to multiple pregnancies. Fortunately, the babies are recovering very quickly (for about half a year) and begin to develop without visible consequences for their health.
Psychologists recommend adult parents:
- Do not “strangle” the child with your care - sing chastooshkas in front of them, you should not write down paid classes in everything or hold competitions for entertainment! It is better to read fairy tales for the night or to make crafts from the magazine with the kid. In short, only a varied holiday will allow to grow a mentally healthy person.
- Do not instill a scion that he is special since he was born from a test tube. He is not worse, but not better - this is just another little man.
Is sterility inherited?
Whether infertility is inherited, scientists still have not figured out. It often happens that sick offspring give birth to healthy offspring, and now the third generation cannot have children again.
Dr. Ramlau-Hansen from Denmark conducted a study in which she interviewed men whose parents were sick with infertility about the mobility of their spermatozoa.
The results showed that a certain proportion of those respondents whose mothers took medication for infertility suffered from low sperm activity. But with what exactly their problem is connected - with heredity or with the harmful influence of medicines - it was not possible to find out.
Unfortunately, female infertility, as practice shows, is transmitted more often than male.
Scientists around the world are more inclined to believe that infertility is heredity, however, no exact evidence was given in favor of such a theory.
How PGD helps to prevent the conception of infertile children
Preimplantation genetic diagnosis (PGD) is a method for diagnosing genetic diseases, which is used in the case of in vitro fertilization.
Its essence lies in the collection of one blastomere (embryo cells at the stage of its formation) on the third day of cultivation of a fertilized egg in laboratory conditions. Such a procedure will not disrupt the further development of the embryo, however, it will allow reproduction specialists and embryonologists to identify a failure in the genetic apparatus of the future baby.
PGD is prescribed in such cases:
- when parents are carriers of such mutations that can change the structure of chromosomes,
- if the father is over 39 years old,
- if the mother’s age is over 35,
- when there are unsuccessful IVF attempts for this pair.
PGD allows you to select the strongest embryo, from which a healthy fetus will then be formed, and the born baby will not suffer from infertility or any other genetic disease.
About the personal experience of a large mother see online in this video:
In vitro fertilization hazards
Artificial insemination is a procedure that is not easy for the body. The risks of IVF are numerous and always worth remembering:
- ovarian hyperstimulation syndrome,
- ectopic or multiple pregnancy,
- deviations in the development of the child,
- complications after surgery, for example, bladder injury,
- problems with thyroid, vessels and other.
Many of the effects are associated with the use of hormones. Moreover, the effectiveness of IVF in most clinics rarely exceeds 30–40%. That is, harm to the body is necessary, and getting pregnant and enduring is not always obtained. The next attempt may simply not be enough health or money.
IVF has been known since 1978. In Russia, the first child with his help was born in 1986. Although many things remain unclear. There are different methods, disputes between specialists still do not subside. For example, some Swedish scientists believe that there are such negative effects of IVF:
- born much more likely to suffer from cancer
- there is a high risk that such children in the future will not be able to become parents themselves.
Some doctors see other threats and consequences. Their colleagues consider some of the warnings to be frivolous, and the dangers only myths.
There are also objective difficulties recognized by all or the majority. IVF is a difficult procedure, not every organism is able to withstand it. For example, it is forbidden to hold if there is:
- malignant tumor in the genitals,
- pathology of the uterus, preventing the consolidation of the fetus,
- inflammation that does not go away
- Mental disorders: treatment is a big burden and emotionally.
Side effects of hormone therapy
Stimulation is carried out with the help of hormonal drugs. This is a big load on the body. Altered hormones can cause:
- tinnitus, hearing loss,
- visual impairment
- menstrual bleeding,
- pathologies of the heart: increased pressure, tachycardia,
- allergies: skin rashes, bronchospasms,
- dry vagina, discomfort during sex,
- thyroid problems
- loss of appetite, nausea and other digestive disorders,
- lethargy, depression,
- metabolic disorders, high blood sugar,
- weight loss, or, conversely, a set of extra pounds.
Read also IVF features in the natural cycle
There are other risks of artificial insemination. Not the fact that the consequences will come. Moreover, do not be afraid that they will appear all at once. Good diagnosis is important to eliminate or mitigate harm.
During stimulation, follicles grow, and then ready-made eggs appear in them. The downsides of IVF here are that the process needs strong drugs. Most of them can lead to the following consequences:
- breast enlargement,
- thromboembolism - blockage of a vessel with a clot brought by blood from another place,
- abdominal pain,
- pathological accumulation of fluid in the chest or abdomen: hydrothorax, ascites,
- digestive disorders, such as bloating or diarrhea,
- ovarian hyperstimulation syndrome (OHSS).
The latter occurs if the effect on the body during IVF is too strong. Treatment is impossible without stimulation of the ovaries, OHSS is only a complication when the process gets out of control. This pathology entails others: the blood thickens, the excretory system works worse. The result is the accumulation of fluid in the stomach, chest.
Кровотечение из кисты
Есть и другие опасности ЭКО. Среди редких осложнений — кисты. Они появляются:
- в результате гормональной терапии,
- после пункции на месте забора фолликула для ЭКО.
Кисты могут представлять серьезную угрозу. A rupture leads to bleeding in the pelvis. The condition can be identified by the following symptoms:
- pain in the perineum or abdomen pulling nature
- lethargy, apathy,
- pressure drops,
- skin becomes pale, sweat acts.
For treatment, you need to perform an operation (laparoscopy). Cysts (resection) or ovaries are removed. Sometimes the formations are punctured, sucking fluid out of them.
Consequences at the main stages of the procedure
Each type of artificial insemination has both advantages and disadvantages. The IVF procedure gives you a chance to give birth, but is associated with health risks. In addition to IVF, artificial insemination is also popular.
The latter is easier to carry out: insemination occurs through the transfer of sperm into the uterus.
The difference is in the conception mechanism: during IVF fertilization occurs in a test tube, and only then the embryo is sent to the female body.
Some of the hazards in both procedures are the same, for example, a slight risk of infection or bleeding. Although IVF is more difficult, so the “pitfalls” are more here. Puncture of the ovaries can end up with damage, injury:
Read also IVF in the Siberian Federal District
However, the risk of such consequences is small. If you believe the statistics, they occur in one case out of a thousand or even less. No less important is the next stage - replanting. The transfer of fertilized eggs can provoke inflammation in the uterus.
In order to have more chances, several embryos are planted during IVF. It happens that they get accustomed to everything, and a multiple pregnancy can occur. Therefore, in most clinics, a maximum of three embryos are planted. If more are possible adverse effects on women and children.
- The load on the body when carrying is greatly increased. Usually there are not enough important substances, such as iron or calcium. Often, chronic diseases are exacerbated. The spinal column is overloaded and suffers.
- If the number of fetuses is 2–3, the risk of premature birth increases. At 4–5, this is almost inevitable. It is unlikely that it will be possible to report at least up to 38 weeks.
- The more children, the less weight they usually have and the more often they suffer from various pathologies. They are often born prematurely.
- Several children develop unevenly. More often it is observed in troenes. One of the children grows much slower, serious violations may appear. For others, this also does not pass without a trace.
- A caesarean section is usually required.
In order to prevent complications, doctors immediately propose to reduce the number of surviving embryos (reduction). As a rule, this is a difficult decision for parents.
Ectopic pregnancy often occurs after conception in a natural way. However, with IVF it is among the possible risks. Especially if the fallopian tubes are removed. The embryo is often attached precisely in the area of the stump.
Prior to rupture of the fallopian tube pathology will be recognized by the following features.
- Unpleasant sensations in the side (any), lower abdomen. Their strength is different: from mild discomfort to intense pain.
- There is no fetus in the uterus, and the tube itself is enlarged. Install using ultrasound.
- The embryo grows worse. A special hormone (chorionic gonadotropin) is used to check pregnancy. His level is lower than it should be.
When a pipe breaks, a life threatening situation occurs. Immediate help from doctors is required. The symptoms here are the following:
- strong pain,
- a woman can lose consciousness
- bleeding from the uterus, blood in the abdominal cavity.
Read also Utrozhestan at IVF
For IVF, heterotopic pregnancy is more common. Here the embryo is fastened both in the uterus and outside at the same time.
Doctors and scientists believe that in vitro fertilization does not have the best effect on children. The probability of malformations is higher. This, for example, cleavage of the sky or lips. In confirmation of the statistics. It is unclear what the reason for this situation.
There are opponents of the theory. It is too early to say that IVF is “guilty” of IVF, and not other modern factors in the consequences.
The situation is different with chromosome damage in the unborn child. Pathologies in this area are caused, for example, by Patau or Down syndrome. With IVF, there are no more such disorders than with conventional fertilization. There is even an advantage: pathologies are found in the embryos and they don’t get damaged. Therefore, IVF is recommended for carriers of dangerous genes, even if they are capable of natural conception.
When carrying out IVF almost always there are psychological difficulties. This is especially true of women.
- The main burden falls on them. Treatment, pregnancy take a long time. Often, all this is accompanied by poor health.
- Women are more prone to experiencing.
There are many reasons for concern, they are individual. However, there are several common problems.
- Decreased self-esteem. It seems to a person that he is physically abnormal.
- High probability of failure. From here - anxiety, depression, irritation.
- IVF, especially with the participation of the donor, is contrary to conservative views, religious principles. A person may suffer because the procedure goes against his beliefs or the opinions of others.
- Social difficulties. Sometimes couples do not share their decisions with others because of fear of condemnation. It is difficult, because a person always needs the support, approval of relatives, the team.
Consequences in the future
IVF can affect the future life of a couple, not always on the good side. Possible consequences include:
- thyroid disease,
- risk of developing cardiomyopathy,
- early menopause,
- life expectancy of a woman after childbirth is reduced, this is a common myth.
There is an opinion that IVF leads to oncology. Impressive women remember Zhanna Friske. IVF erodes health, and the risk of cancer is increasing. However, not everything is so bad.
Most doctors do not see a direct link between the procedure and cancer. Rather, the role played by late pregnancy or predisposition to oncology. Even if health is harmed, it can often be repaired.
The main thing is to consult the right doctor in time.
Are IVF children different from normal?
In Vitro Fertilization, or IVF, is an assistive technology that allows infertile couples to have blood children.
They say about such babies that they originated "from a test tube". Despite its weighty practical significance, IVF and today remains covered with many myths and prejudices.
To determine how reliable they are, it is necessary to present the essence of the procedure.
As the name implies, the fusion of the sperm and egg occurs outside the body of a woman. IVF is indicated for tubal and other infertility factors.
Reproductive specialists puncture the ovary to produce mature germ cells and fertilize them with male sperm. As a result of the merger, embryos are formed, which are later transplanted into the uterine cavity. Thus, conception does take place in the laboratory.
With a successful procedure, the embryo is safely implanted, and the pregnancy begins to progress. For the first time successful in vitro fertilization was carried out in 1978, which led to the birth of a healthy girl.
Since then, this reproductive technology has evolved and improved. In modern obstetrics in developed countries, about three babies out of every hundred newborns are conceived "in vitro".
Such popularity of the method led to the emergence of a wide variety of myths regarding developmental disorders and health problems in these babies, which are sometimes also called “IVF children”.
Why do myths and prejudices arise associated with this technology?
On the one hand, such a method of artificial conception is rather new, and during its implementation there are certain risks that scare partners.
On the other hand, in vitro fertilization is a costly procedure. The state helps infertile couples by inviting them to conduct IVF on a quota. But we are talking only about one or two free attempts. Further procedures are not affordable for many because of the high cost. And sometimes it is much easier to abandon IVF, if you believe in its harm for the unborn child.
What more often scare future parents who are planning to use this technology? The main myths of IVF are:
- Infertility born "from the tube" of the child.
- Disruption of its development - physical and mental.
- The birth of a baby, genetically different from their parents.
- Obligatory appearance of twins or triplets after in vitro fertilization.
Where the rumors came from that a child conceived “in a test tube” will no longer be fruitless in the future is unknown. However, not only patients, but also some medical workers are talking about this.
The Internet is replete with stories about the problems with the conception of their own babies in those people who were born thanks to assisted reproductive technologies. Are IVF children infertile?
In fact, large-scale studies of the fertility of such people have not been conducted. And the technology itself has only been used for forty years, so it’s too early to talk about any delayed consequences.
Infertility myths are justified only when problems with conception among parents are of a genetic nature and are capable of being inherited. There is also evidence that the probability of infertility in boys increases if the father had significant deviations in the spermogram.
Such a common causative factor, such as obstruction of pipes, is not inherited. This means that babies born will not have any problems with fertility.
A striking example of the safety of in vitro fertilization is the independent pregnancy of Louise Brown - the first girl who appeared out of the tube.
What babies are born after IVF?
The myth that children conceived “in vitro” differ significantly from their peers is very popular. Many say that such babies are prone to frequent illnesses - colds, acute respiratory infections, problems with the gastrointestinal tract.
There is also a theory that claims that in vitro conception affects the mental development of children. They may have difficulty adapting, have certain intellectual disabilities, suffer from hyperactivity syndrome or autism.
However, these allegations are completely groundless. IVF is only a conception version. At the same time, the embryo receives the same chromosomal and genetic set from parents as it does during natural fertilization.
Moreover, in vitro fertilization very often before implanting the embryos, pre-implantation diagnosis is performed. It consists in determining the karyotype of the fetus.
What is this procedure for? If the mother is older than 35 years of age or there were genetic mutations in the genus, it makes sense to check the embryo for their presence before transplantation.
Pre-implantation diagnosis prevents the birth of children with Down syndrome, Edwards, Patau and other chromosomal and genetic pathologies, which most often lead to developmental disorders.
That is why the probability of the birth of babies with physical or intellectual disabilities during in vitro fertilization is lower. Children after IVF are usually healthy and develop normally.
Despite the development of medicine, there is still the opinion that with IVF it is impossible to control the process of conception. And as a result, parents can get a genetically alien child.
However, this is not true, and babies born after in vitro fertilization inherit the genetic material of their parents, as do children in natural conception.
Where did such rumors come from? Perhaps this is due to the use of IVF in the treatment of male infertility. Therapy is not always successful, and it happens that a man cannot produce offspring, despite the efforts made. In such a situation, doctors suggest the couple to use donor sperm and, accordingly, the baby will genetically be similar only to the mother.
Doubts about the reliability of the human factor also influence the formation of myths. In carrying out any procedure errors or negligence may occur, which can lead to sad consequences. During in vitro fertilization, the replacement of biological material can subsequently turn into a real tragedy for the family.
And although there are currently no documented grounds for these concerns, the myth of the genetic mismatch of the newborn is very popular among the masses.
Multiple fertility after IVF
Mandatory fertility in vitro fertilization is another persistent myth. But it is confirmed by numerous stories of various mothers who raise twins and triplets after performing this procedure.
Indeed, during IVF, twins and triplets can be born, because to get a long-awaited pregnancy, doctors usually plant several embryos. Recently, this number has been limited to three germs.
But this does not mean that every married couple who turned to assisted reproductive technologies will bring up several children in the near future. Although the probability of this event is significantly higher than with natural conception.
Multiple pregnancy threatens with the following complications:
- Premature birth. They occur in most cases when carrying twins and almost always - with triplets.
- Prematurity of the fruit.
- The smallness of the kids. The more of them, the less each child will weigh at birth.
- The death of one or more embryos during pregnancy.
- The emergence of specific, characteristic only for multiple pregnancies, complications in which one embryo begins to develop at the expense of another.
However, all these difficulties are encountered in the case of a natural multiple gestation. Therefore, it is impossible to call them a feature of children "from the test tube".
Opinion of doctors
Modern reproductive technologies attract the keen interest of doctors of all specialties. But most of all pediatricians can tell about their consequences, because they observe such babies until they come of age.
Today, experts agree that there are no differences between children after in vitro fertilization and natural conception.
They also develop and suffer from the same diseases. Both are similar to their parents and grandparents. They confirm the medical opinion and stories of mothers who become pregnant with this technology. After all, they usually watch their children even more carefully than average parents.
In vitro fertilization is a method of help for infertility, which is actively used throughout the world, and does not affect the fertility, development and genetic set of the born child.
What babies are born after IVF?
Before considering the differences between children born after IVF, it is necessary to understand what causes them:
- All babies are unique. Children of different sex, age, born in any way, differ from each other. In the same couple born children are not similar to each other. A child born using IVF will be different from others because of its uniqueness, like any other. Even identical twins coinciding genetically may differ phenotypically (by external parameters). Children born as a result of IVF will not be different from other children. That is, they will be as different as all the other kids.
- Children who appear in infertile couples receive more attention from their parents. This is a simple explanation. Their wait lasts a few years. By the time the child is born, the parents are already adults, accomplished people. They are consciously preparing for childbirth and are engaged in raising the baby purposefully.
Considering the moral aspect of the question: whether children born after IVF are different from ordinary children can be answered unequivocally: they are individual, like all other babies, and are ordinary boys and girls.
Health of children conceived with IVF
Children inherit the genetic characteristics of their biological parents. That is, people whose egg and sperm were used for fertilization. The health of children conceived with IVF will be different:
- Serious genetic diseases are less common among them, due to the fact that during preparation for IVF abnormalities are detected and such embryos are not used for the procedure. This is of particular importance for age couples. Artificial insemination is preceded by a long period before the detection of infertility, its treatment, and then the protocol itself (or several). The risk of a child with a genetic disease increases with each year of the parents' life, and this test helps to have a child without Down syndrome or another genetic pathology.
- If parental infertility or other diseases were caused by genetic disorders (pelvic bone abnormality and others), then there is a risk of transmitting this disease to the child.
- При использовании донорского генетического материала (яйцеклетки или эякулята) дети ЭКО могут быть более здоровыми, чем родители. Это связано с тем, что они будут наследовать не признаки фактических родителей, а биологических.
- These children require careful attention to the care of the reproductive organs.
For the rest of the parameters, no significant difference was found between children of IVF and ordinary children.
The development of children born IVF
An important aspect is that The development of children born to IVF is not inferior to children with a natural conception. Such children are welcome. Due to the greater seriousness of their parents, including because of their age, the physical and psycho-emotional development of IVF children may outpace their peers.
The totality of genetic characteristics and conditions of further residence received from parents reflects on how many children born of IVF live, how healthy they are and how they develop. No reliable data on differences in equal age categories were revealed.
Paying attention to what problems arise in children born to IVF, it should be noted that in addition to these children will be affected by 2 factors:
- Plurality. Often, children born after IVF have 1-2 siblings. They can be lightweight. This will require additional attention. Find out what the likelihood of twins after IVF.
- Parents age. Every year the number of existing diseases increases. By age 40, a woman during pregnancy will more often suffer from comorbidities. This may affect the health of the child. So, hypertension can lead to a decrease in uteroplacental blood flow, which will affect the baby.
Can babies conceived by IVF give birth?
The answer to this question will depend on the reasons that led to the infertility of their parents. If a mom or dad suffers from a genetic disorder, the child may be as infertile as they are. If the peculiarities of the couple’s life (genital infections, working with ionizing radiation) led to a lack of ability to conceive naturally, then the likelihood of problems with conceiving in a child does not differ from other methods of fertilization. Thus, children born after IVF will differ from ordinary children only in the genetic material transmitted by their parents.